Department of Epidemiology, Institut für Umweltmedizinische Forschung (IUF) at the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Respir Res. 2010 Aug 22;11(1):113. doi: 10.1186/1465-9921-11-113.
While adverse effects of exposure to air pollutants on respiratory health are well studied, little is known about the effect of a reduction in air pollutants on chronic respiratory symptoms and diseases. We investigated whether different declines in air pollution levels in industrialised and rural areas in Germany were associated with changes in respiratory health over a period of about 20 years.
We used data from the SALIA cohort study in Germany (Study on the influence of Air pollution on Lung function, Inflammation and Aging) to assess the association between the prevalence of chronic obstructive pulmonary disease (COPD) and chronic respiratory symptoms and the decline in air pollution exposure. In 1985-1994, 4874 women aged 55-years took part in the baseline investigation. Of these, 2116 participated in a questionnaire follow-up in 2006 and in a subgroup of 402 women lung function was tested in 2008-2009. Generalized estimating equation (GEE) models were used to estimate the effect of a reduction in air pollution on respiratory symptoms and diseases.
Ambient air concentrations of particulate matter with aerodynamic size < 10 microm (PM10) declined in average by 20 microg/m3. Prevalence of chronic cough with phlegm production and mild COPD at baseline investigation compared to follow-up was 9.5% vs. 13.3% and 8.6% vs. 18.2%, respectively. A steeper decline of PM10 was observed in the industrialized areas in comparison to the rural area, this was associated with a weaker increase in prevalence of respiratory symptoms and COPD. Among women who never smoked, the prevalence of chronic cough with phlegm and mild COPD was estimated at 21.4% and 39.5%, respectively, if no air pollution reduction was assumed, and at 13.3% and 17.5%, respectively, if air pollution reduction was assumed.
We concluded that parallel to the decline of ambient air pollution over the last 20 years in the Ruhr area the age-related increase in chronic respiratory diseases and symptoms appears to attenuate in the population of elderly women.
尽管已有大量研究表明，暴露于空气污染物对呼吸道健康的不良影响，但对于空气污染物水平降低对慢性呼吸道症状和疾病的影响知之甚少。我们调查了德国工业化地区和农村地区的空气污染水平不同程度的下降是否与大约 20 年期间呼吸道健康的变化有关。
我们使用了德国 SALIA 队列研究（空气污染对肺功能、炎症和衰老的影响研究）的数据，评估了慢性阻塞性肺疾病（COPD）和慢性呼吸道症状的流行率以及空气污染暴露减少与慢性呼吸道疾病之间的关联。1985-1994 年，4874 名 55 岁的女性参加了基线调查。其中，2116 人参加了 2006 年的问卷调查随访，402 名女性的亚组在 2008-2009 年进行了肺功能测试。使用广义估计方程（GEE）模型来估计空气污染减少对呼吸道症状和疾病的影响。
空气中的颗粒物（空气动力学直径<10 微米）浓度平均下降了 20 微克/立方米。与随访相比，基线调查中慢性咳嗽伴咳痰和轻度 COPD 的流行率分别为 9.5%和 13.3%，8.6%和 18.2%。与农村地区相比，工业化地区的 PM10 下降幅度更大，这与呼吸道症状和 COPD 患病率的增幅较弱有关。对于从不吸烟的女性，如果不假设空气污染减少，则慢性咳嗽伴咳痰和轻度 COPD 的患病率估计分别为 21.4%和 39.5%，如果假设空气污染减少，则分别为 13.3%和 17.5%。
我们得出结论，与过去 20 年来鲁尔地区大气污染水平下降的同时，老年女性人群中与年龄相关的慢性呼吸道疾病和症状的增加似乎有所减弱。
